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Published on: March 26, 2018
Anterior transsternal approach to the upper thoracic spine
A Maciejczak1, A Radek, J Kowalewski
1Dept. of Neurosurgery and General Surgery, University Hospital of the Military Medical Academy, Lódz, Poland.
Acta Chirurgica Hungarica
|August 10, 1999
Summary
Full median sternotomy offers a safe and effective anterior approach for resecting upper thoracic spine tumors. This technique provides superior visualization and control compared to less extensive surgical modifications.
Area of Science:
- Neurosurgery
- Thoracic Surgery
- Spinal Surgery
Background:
- Anterior surgical approaches to the cervicothoracic junction and upper thoracic spine (to T4) are typically performed via sternotomy.
- The transsternal approach is optimal for accessing and resecting lesions within the vertebral bodies of the upper thoracic spine, enabling interbody fusion and reconstruction.
Observation:
- Modifications to the transsternal approach have evolved towards less extensive sternotomies, including manubriotomy with clavicle resection and partial lateral manubriotomies.
- These less invasive techniques offer limited lateral exposure and are technically more challenging.
Findings:
- This study presents two cases of upper thoracic spine tumors operated on using a full median sternotomy.
- Full median sternotomy provides advantages such as technical simplicity for thoracic surgeons, enhanced safety with better mediastinal and great vessel exposure, and improved visualization of the upper thoracic spine (T3-T5).
Implications:
- The full median sternotomy approach allows for a perpendicular view of the anterior spine, facilitating visualization of the posterior longitudinal ligament and dura.
- This technique avoids destabilization of the shoulder girdle and preserves upper limb function, making it a preferred method for specific upper thoracic spine pathologies.
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